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79
would be that much more subject to the risk of contracting this infection.
It is hoped that the resumption of the use of the combined preparation
will result in more children being protected against diphtheria.
During the year, 2,307 children were treated for the first time, 1,415
by general practitioners and 892 at the infant welfare centres. The corresponding
figures for 1958 were 1,934, 1,128 and 806; for 1957 2,135,
1,174 and 962, and in 1956, 2,336, 1,109 and 1,227. It will be noticed
that the increase in the numbers treated is mostly amongst those treated
by general practitioners. The reason is doubtless that many of the general
practitioners continued to use the combined preparation at a time when
its use was discontinued at the clinics.
It was estimated that at the end of the year, 60 per cent of children
under five years of age were protected and 97 per cent of those aged five
to fifteen years. The difference in these two percentages comes about for
two reasons. The one is that it is not the practice to immunise against
diphtheria a very young child. At one time few babies would have completed
their course of immunisation before they were one year old. At
that time even if all were then done before they were five, the percentages
of those under five immunised could not be more than eighty. The same
position holds, though not to the same extent, now that immunisation
against diphtheria is carried out at younger ages; in none of them is
treatment started before the age of six months. The other reason for the
difference is that those in the five to fifteen age group are the carry-over
of those who were inoculated at a period when most infants were receiving
this treatment.
Booster doses were given to 792 children, 460 by general practitioners
and 332 at the clinics.
SCARLET FEVER
For many years now scarlet fever has been a very mild infection,
the change in the severity of the illness presumably being due to a change
in the virulence of the organism. During this phase the incidence has been
most variable. This again is presumably the result of changes in the
invasiveness of the organism. In the last few years the incidence has been
light. In 1955, 125 cases were notified; in the succeeding years, 129, 76
and 134. In this last year the number rose to 202. The rate per thousand
population was 0.90. The corresponding rate for the country as a whole
was 106.
The weekly notification rates over the four quarters were 5, 4, 1 and 5.
The type of infection remained mild. Scarlet fever today causes very
tew deaths. The last case contracted in this district which proved fatal
was in 1937.
Very small numbers of patients suffering from scarlet fever are now
removed to hospital. This last year the number was only five, and of those
iee were transferred from other hospitals.